2004 USMLE Performance Data
As published in the 2004 NBME Annual Report,
Copyright 2005 by the National Board of Medical Examiners®

USMLE Administration, Minimum Passing Scores, and Performance

Continuous test administration of the USMLE is available to all examinees. Prometric, Inc.®, part of The Thomson Corporation™, provides scheduling and test centers for computer-based testing (CBT) components of the USMLE program, including Step 1, Step 2 Clinical Knowledge (CK), and Step 3. These CBT examinations are currently administered at more than 300 US/Canadian Prometric test centers and more than 200 international Prometric test centers. Additional test centers are located at eight medical schools in the United States. The Step 1 and Step 2 CK examinations are administered worldwide; the Step 3 examination is administered only in the United States.

After completion of the registration process and receipt of certification of eligibility, applicants for Step 1, Step 2 CK, or Step 3 contact the Prometric scheduling network to make an appointment to take the examination at a location and time most convenient to the applicant's schedule. Examination results are processed continuously, and scores are reported weekly. Most Step 1 and Step 2 CK examinees receive their scores approximately three to four weeks after their test date and most Step 3 examinees, four to six weeks. Individual score reports are mailed to examinees; medical schools and state licensing authorities can receive score information by using a secure website.

The USMLE program recommends a minimum passing score for each Step of the USMLE. Minimum passing scores are based on achievement of specified levels of proficiency established prior to administration of examinations. Statistical procedures are employed to insure that for each Step, the level of proficiency required to pass remains uniform across forms of the examination. As noted in the USMLE Bulletin of Information and at the USMLE website, the score required to meet the recommended level of proficiency is reviewed periodically and may be adjusted without prior notice. Notice of adjustments is posted on the Internet at www.usmle.org.

In reviewing standards for USMLE examinations, the USMLE Step Committees employ information gathered from a number of sources including standard setting surveys. These surveys, which seek opinions on the appropriateness of current USMLE pass/fail standards for each of the Steps, are sent to random samples of examinees, directors of basic and clinical science courses and clinical clerkships, associate deans for academic and student affairs, directors and chief residents from residency programs, members of USMLE test material development committees, executive directors and presidents of all state medical boards, and members of the NBME Board and FSMB Board of Directors.

In addition to surveys, USMLE Step Committees consider the results of content review by standard setting panels. These panels typically consist of physicians who are not otherwise involved in the USMLE program. These panels review the content of the Step examinations and, through a series of exercises, provide data that reflect their opinions on minimally acceptable levels of performance.

Step 1

Details on the performance of examinees taking Step 1 in 2003 and 2004 are provided below. Data for 2004 are based upon examinees whose results were reported through February 16, 2005. Approximately 16,600 and 16,700 first-time takers from US and Canadian medical schools that grant the MD degree were tested in 2003 and 2004, respectively. First-time takers from non-US/Canadian medical schools numbered approximately 12,400 and 12,300 for the same years. The pass rate for first-time takers from MD-granting US and Canadian medical schools was 93% in both years. Because failing examinees generally retake Step 1, the ultimate passing rate across test administrations is expected to increase to approximately 99% for this same group.

TABLE 1 - 2003-2004 STEP 1 ADMINISTRATIONS
Number Tested and Percent Passing
2003 2004*
#Tested %Passing #Tested %Passing
Examinees from US/Canadian Schools that Grant
MD Degree 18,565 90% 18,355 91%
1st Takers 16,633 93% 16,703 93%
Repeaters** 1,932 62% 1,652 64%
DO Degree 1,043 73% 1,192 69%
1st Takers 988 74% 1,131 70%
Repeaters** 55 44% 61 53%
Total US/Canadian 19,608 89% 19,547 89%
Examinees from Non-US/Canadian Schools
1st Takers 12,415 65% 12,251 67%
Repeaters** 6,098 42% 5,964 40%
Total non-US/Canadian 18,513 57% 18,215 58%
* Represents data for examinees tested in 2004 and reported through February 16, 2005.
** ‘Repeaters’ represents examinations given, not number of different examinees.

Step 2 CK

Details on the performance of examinees taking Step 2 CK in the 2002-2003 and 2003-2004 academic years are provided below. First-time takers from US and Canadian medical schools granting the MD degree numbered approximately 16,100 and 16,400 for the 2002-2003 and 2003-2004 periods, respectively. First-time takers from non-US/Canadian medical schools numbered approximately 9,600 and 9,900 for the same years. The pass rates for first-time takers from MD-granting US and Canadian medical schools were 96% and 94%, respectively. As noted with Step 1, given the opportunity for this same group to repeat the examination, the ultimate Step 2 CK passing rate across test administrations is expected to increase to approximately 99%.

TABLE 2 - 2002-2004 STEP 2 CK ADMINISTRATIONS
Number Tested and Percent Passing
2002-2003* 2003-2004*
#Tested %Passing #Tested %Passing
Examinees from US/Canadian Schools that Grant
MD Degree 17,042 94% 17,772 92%
1st Takers 16,119 96% 16,431 94%
Repeaters** 923 64% 1,341 67%
DO Degree 354 88% 439 76%
1st Takers 346 88% 413 80%
Repeaters** 8 50% 26 23%
Total US/Canadian 17,396 94% 18,211 92%
Examinees from Non-US/Canadian Schools
1st Takers 9,636 79% 9,862 75%
Repeaters** 2,732 47% 3,178 46%
Total non-US/Canadian 12,368 72% 13,040 68%
* Data for Step 2 CK are provided for examinees tested during the period from July 1 to June 30.
** ‘Repeaters’ represents examinations given, not number of different examinees.

Step 3

Details on the performance of examinees taking Step 3 in 2003 and 2004 are provided below. Data for 2004 are based upon examinees whose results were reported through February 16, 2005. First-time takers who were graduates of MD-granting schools in the US and Canada numbered approximately 16,300 in 2003 and 16,400 in 2004. First-time takers who were graduates of non-US/Canadian medical schools numbered approximately 8,100 and 7,700 for the same years. For 2003 and 2004, the pass rates for first-time takers who were graduates of MD-granting US and Canadian medical schools were 95% and 96%, respectively. Like Step 1 and Step 2 CK, the ultimate Step 3 passing rate, accounting for repeat attempts, is expected to increase to approximately 99% for this same group.

TABLE 3 - 2003-2004 STEP 3 ADMINISTRATIONS
Number Tested and Percent Passing
2003 2004*
#Tested %Passing #Tested %Passing
Examinees from US/Canadian Schools that Grant
MD Degree 17,540 93% 17,600 94%
1st Takers 16,299 95% 16,446 96%
Repeaters** 1,241 65% 1,154 69%
DO Degree 82 90% 85 93%
1st Takers 76 92% 81 93%
Repeaters** 6 67% 4 †
Total US/Canadian 17,622 93% 17,685 94%
Examinees from Non-US/Canadian Schools
1st Takers 8,074 68% 7,668 74%
Repeaters** 5,407 47% 4,791 57%
Total non-US/Canadian 13,481 60% 12,459 68%
* Represents data for examinees tested in 2004 and reported through February 16, 2005.
** ‘Repeaters’ represents examinations given, not number of different examinees.
† Performance data not reported for catagories containing fewer than 5 examinees.